Electronic apparatus control using a breathing assistance apparatus

ABSTRACT

A breathing gases supply apparatus  1  can comprise a blower  103/105  and breathing circuit for delivering breathing gases to a patient. The apparatus also can comprise a first controller  109 , the controller  109  configured to receive input from at least one sensor  110 - 112  indicative of patient breathing, and a transmitter  201  configured to communicate with the controller  109  and transmit control signals to an electronic apparatus  203 . The controller  109  can be configured to determine sleep in a patient based on the occurrence of a breathing pattern indicative of sleep, detected from the input received from the sensor  110 - 112  and upon determining sleep, operate the transmitter  201  to send a control signal to control an electronic apparatus  203.

INCORPORATION BY REFERENCE TO ANY PRIORITY APPLICATIONS

Any and all applications for which a foreign or domestic priority claimis identified in the Application Data Sheet as filed with the presentapplication are hereby incorporated by reference under 37 C.F.R. § 1.57.

BACKGROUND OF THE INVENTION Field of the Invention

The present invention relates to a breathing assistance apparatus and amethod implemented by a breathing assistance apparatus (breathing gasessupply apparatus) for remotely controlling electronic apparatus such ashome appliances or electronics. The breathing apparatus could be, forexample, a PAP apparatus.

Description of the Related Art

Respiratory disorders affect the ability of a sufferer to breathe. Onetreatment of respiratory disorder involves delivering pressurisedbreathing gases to a person experiencing the disorder. A commonrespiratory disorder is an apnea. Apneas are caused by the collapse ofthe muscles supporting a person's airways during sleep, resulting in apartial or complete blockage of the breathing passages. This is commonlyknown as Obstructive Sleep Apnea (OSA). Other events such as hypopneasand restricted breathing (flow limitations) also fall into the broadcategory of sleep disorder breathing (SDB) events. A hypopnea involvesepisodes of overly shallow breathing or an abnormally low respiratoryrate. Restricted breathing is caused by a restriction in the person'sairway most commonly caused by the person's airway partially closing.These events (that is, SDB events) also occur during sleep and cause aperson to wake mid sleep, and can limit the amount of sleep a person canget.

SDB events are commonly treated using Positive Airway Pressure (PAP)therapy. PAP involves delivering breathing gases at a pre-determinedpressure above atmospheric to the patient. The raised pressure breathinggases force the user's airways open to maintain a substantiallyunrestricted breathing passage. The predetermined pressure at whichtreatment is delivered is generally determined by clinical trials priorto regular treatment. In particular Continuous Positive Airway Pressure(CPAP) therapy is used to treat SDB events. In basic CPAP therapy thepressure is constantly maintained at a predetermined pressure. There areother PAP therapies like Bi level PAP and auto CPAP in which there is ahigh positive pressure at inspiration and a lower pressure at expirationis delivered to maintain open airways.

PAP therapy is delivered to a patient by a treatment system fordelivering breathing gases to the patient. The system typically includesa flow generator for generating a flow of gases, a conduit to transportthe breathing gases generated by the flow generator, and a patientinterface to deliver the gases to the patient. The system may include ahumidifier to humidify the breathing gases prior to delivering the gasesto a user.

PAP treatment systems are generally used in the home by a user. PAPtreatment systems are used by a person or patient during sleep toprevent SDB events such as OSA and sometimes provide inspiratoryassistance, as is the case for bi-level PAP. However PAP treatmentsystems are also utilised by a person when the person is awake andpreparing for sleep. The treatment system continues to operate after theperson has fallen asleep.

SUMMARY OF THE INVENTION

Quite often the user or person is watching TV or listening to the radioor has other appliances or electrical apparatuses operating while theuser is using a PAP treatment system. As the user falls asleep theseappliances may remain switched on without the user realising. Forexample, the user may be watching TV, utilising the PAP treatment systemand falls asleep and the TV continues to run throughout the nightcausing excessive power use. Another example is the user may be in bedor on the couch using the PAP treatment system and falls asleep whilethe lights remain on throughout the night. This is again disadvantageousbecause it causes higher power consumption.

It is an object of the present invention to control an electronicapparatus using a breathing gases supply apparatus or at least providethe public with a useful choice.

The terms “sleep” and “asleep” as used in this specification areintended to encompass a) the onset of sleep, b) an actual sleep statewhere the patient is asleep (such as the REM sleep state and the non-REMsleep state), or c) a change in sleep state, for example from non-REMsleep to REM sleep or any other such sleep state change. A change insleep state can also be considered the onset of sleep, going from anon-sleep state to a sleep state.

In one aspect the present invention may be said to consist in abreathing gases supply apparatus comprising: a blower and breathingcircuit for delivering breathing gases to a patient, a first controller,the controller configured to receive input from at least one sensorindicative of patient breathing, a transmitter configured to communicatewith the controller and transmit control signals to an electronicapparatus, wherein the controller is configured to determine sleep in apatient based on the occurrence of a breathing pattern indicative ofsleep, detected from the input received from the sensor and upondetermining sleep, operate the transmitter to send a control signal tocontrol an electronic apparatus.

Preferably the sensor measures breath flow of a patient.

Preferably the breathing pattern indicative of sleep is a sleep disorderbreathing (SDB) event.

Preferably the breathing pattern indicative of sleep is a rhythmic orerratic breathing pattern, or a change between a rhythmic or erraticbreathing pattern.

Preferably the breathing gases supply apparatus comprises a PAPapparatus.

Preferably the apparatus further comprises at least one sensor.

Preferably the sensor is any one or more of the following: flow sensor,pressure sensor, humidity sensor, sound sensor (such as a microphone),mass flow sensor, voltage sensor, current sensor, sensor or sensors todetermine the state of the electronic apparatus, EEG sensor, positionsensor, or accelerometer

Preferably the first controller is further configured to control theblower and breathing circuit.

Preferably the first controller is integrated in the breathing gasessupply apparatus.

Preferably the first controller is removable from the breathing gasessupply apparatus.

Preferably the first controller is remote from and communicates with thebreathing gases supply apparatus.

Preferably the breathing gases supply apparatus further comprises asecond controller configured to control the blower and breathingcircuit.

Preferably the first or second controller is configured to control theusual operations of the apparatus based on the input from at the sensorindicative of patient breathing, and/or from the determined breathingpattern indicative of sleep.

Preferably either the first controller or second controller isconfigured to determine sleep based on the any one or more of thefollowing: number of SDB events, duration of SDB events, spread of SDBevents, and types of SDB events.

Preferably the SDB event is one or more of a flow limitation, hypopneaor apnea.

Preferably the control signal changes the state of the electronicapparatus.

Preferably the control signal switches off an electronic apparatus.

Preferably the transmitter utilises infrared, RF or sonic energy to sendthe control signal.

Preferably the electronic apparatus is further configured to transmit asignal to the controller and the controller further configured toreceive the signal from the electronic apparatus.

Preferably the electronic apparatus is one or more of a: television,radio, lights, heater, air conditioner, heat pump, media player.

In another aspect the present invention may be said to consist in amethod for controlling an electronic apparatus using a breathing gasessupply apparatus for delivering breathing gases to a patient, the methodcomprising the steps of: obtaining input indicative of a patient'sbreathing, determining sleep in a patient based on the occurrence of abreathing pattern indicative of sleep from the input, upon determiningsleep, operating a transmitter to send a control signal to control anelectronic apparatus.

Preferably the input is indicative of the breath flow of a patient.

Preferably the breathing pattern indicative of sleep is a sleep disorderbreathing (SDB) event.

Preferably the breathing pattern indicative of sleep is a rhythmic orerratic breathing pattern, or a change between a rhythmic or erraticbreathing pattern.

Preferably the sensor is any one of the following: flow sensor, pressuresensor, humidity sensor, sound sensor (such as a microphone), mass flowsensor, voltage sensor, current sensor, sensor or sensors to determinethe state of the electronic apparatus, EEG sensor.

Preferably the first controller or second controller is configured todetermine sleep based on the one or more of the: number of SDB events,duration of SDB events, spread of SDB events, types of SDB events.

Preferably the SDB event being any one of a flow limitation, hypopnea orapnea.

Preferably the control signal is sent using infrared, RF or sonicenergy.

Preferably the electronic apparatus is one or more of: television,radio, lights, heater, air conditioner, heat pump, media player, alarmdevice (such as an alarm clock).

Preferably the control signal changes the state of the electronicapparatus.

Preferably the control signal switches off or on the electronicapparatus.

Preferably the input indicative of patient's breathing is further usedto control the breathing gases supply apparatus.

Preferably the method further comprising the step of: determining thecurrent state of an electronic apparatus when the PAP apparatus isswitched on to deliver breathing gases.

In another aspect the present invention may be said to consist in abreathing gases supply apparatus comprising: a blower and breathingcircuit for delivering breathing gases to a patient, a first controller,the controller configured to receive input from at least one sensorindicative of patient breathing, a transmitter configured to communicatewith the controller and transmit control signals to an alarm device,wherein the controller is configured to determine a sleep state in apatient and operate the transmitter to send a control signal to activatethe alarm of an alarm device when a desired time is reached and thepatient is in a sleep state conducive to being woken.

In another aspect the present invention may be said to consist in amethod for controlling an alarm device using a breathing gases supplyapparatus for delivering breathing gases to a patient, the methodcomprising the steps of: determining a sleep state in a patient, uponreaching a desired time and determining a sleep state conducive to beingwoken, operating a transmitter to send a control signal to control anelectronic apparatus.

The term “comprising” is used in the specification and claims, means“consisting at least in part of”. When interpreting a statement in thisspecification and claims that includes “comprising”, features other thanthat or those prefaced by the term may also be present. Related termssuch as “comprise” and “comprises” are to be interpreted in the samemanner.

In this specification where reference has been made to patentspecifications, other external documents, or other sources ofinformation, this is generally for the purpose of providing a contextfor discussing the features of the invention. Unless specifically statedotherwise, reference to such external documents is not to be construedas an admission that such documents, or such sources of information, inany jurisdiction, are prior art, or form part of the common generalknowledge in the art.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a block diagram illustrating a gas supply device forimplementing or performing the present invention.

FIG. 2 is a block diagram of the control system that is part of the gassupply device that implements or performs the present invention, thefigure also showing the interaction of the control system and electronicapparatuses such as appliances.

FIG. 3 is a flow diagram illustrating a control method according to thepresent invention which can be implemented by the controller of a gassupply device or system.

FIG. 4 is a block diagram of the control system that is part of the gassupply device that implements or performs the present invention, thefigure also showing the interaction of the control system and electronicapparatuses such as appliances and alarm devices.

FIG. 5 is a flow diagram illustrating a control method for an alarmdevice according to the present invention which can be implemented bythe controller of a gas supply device or system.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT Overview

The present invention provides a method and apparatus for controlling anelectronic apparatus such as a home appliance, using a PAP apparatus orother breathing assistance apparatus (breathing gases supply apparatus).The present invention also relates to a PAP apparatus that can controlan electronic apparatus. The occurrence of an SDB event or other eventor pattern of breathing indicative of sleep determined by the PAPapparatus can serve as an indicator that the person is asleep, and canbe used as a trigger to control an electronic apparatus. As notedearlier, the terms “asleep” and “sleep” should be interpreted broadlyand can cover various sleep states comprising the onset of sleep, actualsleep and also a change in sleep state. So the SDB or other event orpattern of breathing indicative of sleep can serve as an indicator ofactual sleep, and/or onset of sleep or change in sleep state. Any ofthese types of sleep, once detected can be used to trigger to control anelectronic apparatus.

An electronic apparatus can be interpreted generally to cover any typeof electrical or electronic equipment such as home appliances and/orother electrical/electronic devices. For example, an electronicapparatus could be one or more of a: television, radio, light, heater,air conditioner, heat pump, media player, alarm device (such as an alarmclock).

In one embodiment, a PAP apparatus is configured to measure data orparameters indicative of a patient's breathing (such as breath flowdata/parameters or pressure data/parameters), determine the occurrenceof an SDB event or other sleep indicative breathing pattern (e.g. sleepindicative breathing characteristic) in a controller/control system,from that determine sleep in the person (e.g. if the person is actuallyasleep, has reached onset of sleep or has changed sleep state), andcontrol one or more electronic apparatus based on the determination.

Common breathing patterns indicative of sleep are SDB events, whichcomprise apneas, hypopneas and flow restrictions in the airways. Otherbreathing patterns detected or determined can be a lower tidal volume, alower breath rate, lack of variability or a change in pulse rate. Anyone or more or a combination of one or more changes listed above can bedetected or determined by the system. Such changes in the breathingresult in a breathing pattern indicative of sleep. Breathingcharacteristics that may be indicative of sleep, and are detected ordetermined by the controller are tidal volumes breathing rates, pulserates and variability in breathing. Any one or more of these or acombination of these can be indicative of sleep.

In general, the PAP apparatus can from the flow or pressuredata/parameters determine any patterns that indicate sleep, and fromthat trigger control of an electronic apparatus.

Breathing Apparatus

FIG. 1 is a block diagram illustrating one embodiment of a breathinggases supply system/apparatus 1 incorporating the present invention. Thefull system comprises a PAP apparatus 100 for delivering a supply ofbreathing gases, a breathing circuit 101 and a patient interface 102.

The supply conduit 101 extends from an outlet in the PAP apparatus 100and to the patient interface 102. The patient interface may be anysuitable sealing patient interface such as a full face mask, nasal mask,nasal pillows, oro-nasal mask, oral mask, oral interface, nasal seal,nasal cannula or the like.

The PAP apparatus 100 comprises a blower. The blower preferablycomprises a fan 103 driven by an electric motor 105. Air is drawn intothe PAP apparatus 100 through the inlet 104 by the fan 103. Pressurisedair leaves the fan 103 for supply to the patient. Alternatively,controllable flow generators may draw on a source of high pressure gas,and regulate a flow of gas from the high pressure source.

The PAP apparatus 100 preferably comprises a humidifier 115, as shown inthe embodiment of FIG. 1. In alternative embodiments, the humidifier 115may be separate from the PAP apparatus and part of the breathing gasessupply system 1 or alternatively there may be no humidifier 115 present.The humidifier 115 as shown in FIG. 1 is a pass over type humidifierwhere air passing through the humidifier picks up a quantity of watervapour from a reservoir of water 107. The water reservoir 107 may beheated by a heater 108. The humidifier 115 is preferably integrated intothe housing of the PAP apparatus 100. Alternatively the humidifier 115may be a separate component within the housing of the PAP apparatus orseparate from the PAP apparatus 100 with a conduit connecting betweenthe PAP apparatus 100 and the humidifier 115. Other types ofhumidifiers, other than a pass over type may be used. In some formsmultiple humidifiers may used in the breathing gases supply system 1.

The heater 108 and the motor 105 are supplied by a power supply (PS)106. The amount of power supplied to the motor determines the speed thefan 103 turns at. The amount of power supplied to the heater 108determines the amount of water vapour produced by the humidifier 115 andhence is one way of controlling the amount of humidification of thebreathing gases supplied by the PAP apparatus 100. The amount of powersupplied by the power supply 106 is controlled by the outputs of acontroller.

The PAP apparatus comprises at least a first controller 109. The firstcontroller 109 is used to control the blower and breathing circuit. Thecontroller 109 may also be configured to control other components asdescribed later. The controller 109 is supplied by power from the powersupply 106. The controller receives inputs from a user interface (UI)113. The user interface could be in the form of any suitable userinterface such as a knob, a plurality of buttons, a screen or anycombination thereof. The user interface 113 allows the PAP apparatus 100to display information to the user and also allows a user to inputinformation to the PAP apparatus, more particularly to the controller109. The controller 109 may also be provided with an interface 114 forconnecting to an external data source. The external data source may forexample, be a communication interface such as a modem, or may be aninterface to an external memory such as a smart card, USB, flash drive,disk drive or the like. The interface is capable of connection with amobile storage device. For generic use, the interface 114 may be a datacommunications port according to any available standards for example auniversal serial bus (USB) port. The interface 114 may alternatively oradditionally be capable of wireless communications using any suitabletechnology such as RF (e.g. Bluetooth™), infrared or soniccommunications technology. The interface 114 may also be capable forconnecting to a wide range of peripheral devices.

The controller 109 typically comprises an embedded microcomputer withstored control programs for controlling and operation of various aspectsof the PAP apparatus 100. Alternatively, the controller 109 may beremovable from the PAP apparatus 100. In a further alternative form thecontroller 109 can be remote to the PAP apparatus 100. The controller109 and the components of the PAP apparatus 100 and the components ofthe breathing gases supply apparatus 1 can be configured to communicateby wired or wireless methods.

The controller 109 preferably comprises inputs for receiving inputs fromone or more sensors, which preferably comprise a flow sensor 110, apressure sensor 111 downstream to the fan and a flow sensor 112 that isplaced close to or on the patient interface to determine the flow orvelocity of gases supplied to the patient or user. The flow sensor 110may be positioned upstream or downstream to the fan 103. The sensorsshown in FIG. 1 are one configuration of sensors that can be used in thebreathing gases supply system 1. Any other configuration of sensors andany other types of sensors may be used. There may be fewer or moresensors than those shown in FIG. 1. There may be a variety of othersensors that measure other data such as humidity sensors, mass flowsensors, temperature sensors, EEG sensors and the like. In a preferredembodiment, as illustrated in FIG. 1, the breathing gases supply system1 comprises a flow sensor 110, a pressure sensor 111 in the PAPapparatus 100 and a flow sensor 112 adjacent the patient interface 102.The information/data measured by the sensors, that is flow and pressure,can be referred to as breathing information/data because it relates tothe breathing of the patient. The two common parameters measured arepressure and flow of gases breathed or supplied to the patient or user.

While the controller 109 might comprise a microprocessor implementingthe control programs, it could alternatively comprise a programmed logiccircuit (such as an FPGA) implementing the control programmed, or anyother suitable implementation. Electronic circuits and logic circuitsimplementing the control programme may be readily devised by personsskilled in the art. The control program/controller functionality will bedescribed later in detail with respect to FIG. 3.

The PAP apparatus has a control system 200 configured for operatingelectronic apparatus 203 upon determining sleep (that is, actual sleep,onset of sleep or change in sleep state). The control system 200 cancomprise a controller and other components of the PAP apparatus alreadydescribed in relation to FIG. 1. FIG. 2 shows a block diagram of thecontrol system 200 of the PAP apparatus 100 in further detail showinghow it is configured to operate electronic apparatus 203 upondetermining sleep in a patient.

The control system 200 comprises at least one sensor to detect/measurebreathing parameters (these being sensor(s) that might already form partof the PAP apparatus), a controller for determining sleep, and atransmitter 201 operated by the control to communicate with anelectronic apparatus such as a home appliance to control it upon sleep.The control system 200 preferably forms part of the breathing gasessupply system 1. Preferably the control system 200 is part of the PAPapparatus 100. Alternatively only some components of the control system200 are housed within the PAP apparatus 100 or formed integrally withinthe PAP apparatus 100. Some or all of the other components of thecontrol system 200 can be positioned outside the PAP apparatus 100.

In one embodiment, as per FIG. 2, the control system 200 comprises thesensors 110, 111, 112, and the controller 109 mentioned previously. Thatis, the controller 109 and sensors 110, 111 and 112 that are used forthe normal operation of the PAP apparatus also form part of the controlsystem 200 for operating electronic apparatus upon determining sleep. Insuch an embodiment, the controller 109 receives data indicative ofpatient breathing from the sensors 110, 111, 112 or any other sensorsand is programmed to process the data received from the sensors. Thecontroller 109 processes the data to determine sleep in a patient basedon the occurrence of SDB events detected from the received data. Inparticular, it is programmed to detect SDB events from the receiveddata, and from one or more of those detected SDB events, determinepatient sleep.

In this context SDB events comprise but are not limited to apneas,hypopneas, and flow limitations. The controller 109 can determine sleepby the detection of a single SDB event based on the presumption that SDBevents only occur during sleeping. Alternatively, the sleep can bedetermined from a combination of quantitative and/or qualitativeanalysis of one or more detected SDB events. For example, sleep can bedetermined based on the: number of SDB events, duration of SDB events,spread of SDB events, and/or types of SDB events.

Alternatively, sleep can be determined by determining another breathingpattern indicative of sleep. Other sleep indicative breathing patternsare determined by measuring characteristics/parameters of breathing flowor pressure. These sleep indicative breathing patterns can be determinedby, for example, measuring and processing a change in tidal volume, areduced tidal volume, a reduced breathing rate, lack of variability inbreathing or a change in the pulse rate. It should be realised breathingpatterns indicative of sleep can be determined by measuring any othersuitable characteristic/parameter of breathing flow or pressure besidesthe ones listed above.

The controller 109 can be pre-programmed during manufacture of thecontroller, or manufacture of the PAP apparatus 100. Alternatively thecontroller 109 may be programmed at a later point, by a suitable person.The program can be loaded onto the controller 109 by any suitable deviceor method. For example program is loaded onto the controller 109 by amobile storage device that can be connected to the controller 109 viathe interface 114. The mobile storage device may be a smart card, amicro-chip, a flash drive, a portable hard drive or any other suchsuitable device.

The controller 109 can be programmed with any suitable method todetermine sleep and/or detect the occurrence of SDB events or otherbreathing pattern indicative of sleep from the sensor data. Preferablythe controller 109 utilises a method that can process a variety ofdifferent input types to determine the occurrence of SDB events or otherbreathing pattern indicative of sleep based on the data measured by thesensors, e.g. 110, 111, and 112).

One such suitable method of determining the occurrence of an SDB event,like an apnea, hypopnoea or a flow limitation is described in U.S.patent application Ser. No. 11/198,072. U.S. patent application Ser. No.11/198,072 describes a system that determines events by analysing theflow signal provided by a flow sensor. The system determines an apneabased on a period where the flow signal indicates a lack of patientbreathing. The system determines a hypopnea based on a period of reducedbreathing volume. The system determines obstructed breathing (flowlimitation) on an analysis of the discrete energy spectrum of the flowsignal of patient breaths. The controller 109 can implement the methodor methods of determining various SDB events such as apneas, hypopneasor flow limitations, as described in U.S. patent application Ser. No.11/198,072, the contents of which are herein incorporated by reference.Other suitable alternative methods of determining the occurrence of SDBevents, such apneas, hypopneas and flow limitations can also beimplemented. In alternative methods SDB events may be determined basedon the changes in the pressure signal from the pressure sensor, or SDBevents may be determined based on signals from any other suitablesensor. The controller 109 may implement any one method or anycombination of any methods described earlier.

Alternatively, or as well as detecting SDB events, the PAP is arrangedto determine other sleep indicative breathing patterns are determined bymeasuring characteristics/parameters of breathing flow or pressure. U.S.Pat. No. 6,988,994 describes methods for using breathing patterns todetermine a patient's state, including their sleep state. This patentdescribes determining a regular breathing state, an SDB state and REMsleep state and a trouble wakefulness state. For example, a change fromerratic to rhythmic breathing or vice versa might indicate or detectionof just one of those states could be a breathing pattern indicative ofsleep. Any of these breathing patterns or the states could be used toinfer sleep in a patient for use in triggering control of an electronicapparatus. The contents of U.S. Pat. No. 6,988,994 are hereinincorporated by reference.

The controller 109 determines the SDB event or other breathing patternindicative of sleep for as part of its normal operation as part of thenormal operation of the PAP apparatus. The breathing pattern(s)indicative of sleep are preferably also used for triggering control ofother operations of the PAP apparatus during its normal used, such asfor altering pressure and flow rates.

The controller 109 can also be programmed with sleep indicativebreathing patterns (such as breathing pattern characteristics indicativeof sleep.) The controller 109 determines breathing patterns and measurescharacteristics like tidal volume, variability of breathing, breathrate, pulse rate and any other suitable pattern or characteristic fromthe sensor data fed to the controller. The controller 109 compares themeasured breathing pattern or breathing characteristics with thepre-programmed breathing patterns and determines if the measuredbreathing pattern is indicative of sleep. If the measured breathingpattern or breathing characteristic is identical or substantiallysimilar to the stored sleep indicative breathing, the controller 109determines if sleep has occurred in a patient.

In a further embodiment the controller 109 may store particularbreathing characteristics indicative of sleep. Examples may be a settidal volume, a set breathing rate, a set pulse rate, a set variabilityor any other suitable characteristic. The controller 109 can determinebreathing characteristics from the data measured by the sensors. Oncethe breathing characteristics have been measured the controller 109 cancheck the determined breathing characteristic with the storedcharacteristic indicative of sleep. If the determined breathingcharacteristic is similar to the stored characteristic the controller109 resolves the patient is sleeping.

The controller 109 determines the sleep based on the SDB events, orother breathing pattern of the patient indicative of sleep, or thebreathing characteristics or a combination of any two or all of theseparameters. The controller 109 preferably uses a combination of allthree parameters to provide better accuracy to determine sleep in apatient.

The transmitter 201 of the control system 200 is connected orconnectable to the controller 109 and the power supply. The controller109 is configured to operate the transmitter 201 to send control signalsgenerated by the controller to one or more electronic apparatus 203 tocontrol one or more of the electronic apparatus 203. As anotheralternative, the transmitter 201 can produce a signal once it receives acontrol signal from the controller 109. The transmitter 201 communicateswith electronic apparatus 203 via a suitable medium, such as: RF,Infrared, sonic/ultrasonic, using a suitable wireless protocol such as:Bluetooth™, WIFI™.

Any suitable transmitter 201 can be used with the PAP apparatus 100 andcontroller 109. Preferably the transmitter 201 is positioned within thePAP apparatus 100, as shown in FIGS. 1 and 2, or formed integrally intothe PAP apparatus 100. Alternatively the transmitter 201 can be separateand remote to the PAP apparatus 100 and either wired to the controller109 or alternatively wirelessly in communication with the controller109. In another alternative, a transceiver is used instead of atransmitter. In this case, there can be two way communications betweenthe electronic apparatus 203 and the transceiver 201, meaning thetransceiver 201 can also receive signals from the electronic apparatus203. These return signals could be related to the operation of theelectronic apparatus 203.

Once the controller 109 determines sleep, it generates a control signaland operates the transmitter 201 to send the control signal towirelessly control the operation of any electronic apparatus 203associated with the system/PAP apparatus, as shown in FIG. 2. Thecontrol signal sent from the transmitter 201 changes the state of theelectronic apparatus 203. For example, the transmitter 201 can send asignal to switch off or on appliances such as televisions, radios,electric heaters, media players or other electronic apparatus such aslights, heat pumps, air conditioners, alarm devices (such as alarmclocks) and the like. Alternatively the transmitter 201 can send asignal to change the state of the electronic apparatus 203. For example,it can reduce the volume of televisions, radios and media players, orreduce the intensity of heaters/air conditioners or dim lights. Thetransmitter 201 can also be configured to switch on electronic apparatus203. The controller 109 or transmitter 201 can be configured tocommunicate with and control a plurality of appliances and otherelectronic devices simultaneously.

Method of Control

FIG. 3 shows a method for controlling electronic apparatus with a PAPapparatus 100, in particular using the control system within a PAPapparatus as per FIG. 2. The controller 109 is configured (e.g. via aprogram) to implement the method. In overview, the method comprises thesteps of obtaining input (data/information) indicative of a patient'sbreathing at step 301. The next step involves determining/detecting theoccurrence of SDB events or other breathing pattern indicative of sleepat step 302. Step 303 involves determining if there is sleep. Step 304comprises sending a control signal to an electronic apparatus 203 ifsleep is detected at step 303.

The method for controlling electronic apparatuses 203 using a PAPapparatus commences at step 301. At step 301 the controller 109 receivesinput (information/data) from the one or more sensors (e.g. 110, 111,and 112). Step 301 is periodically performed by the controller 109 at asuitable sampling rate. The sampling rate is determined by the internalclock of the controller 109 or any other clock within the PAP apparatus100. Once data from the sensors has been received by the controller 109,the controller 109 processes the sensor data to detect the occurrence ofone or more SDB events or other breathing pattern indicative of sleep atstep 302. Optionally, the controller 109 uses the method or methods ofdetermining SDB events such as apneas, hypopneas or flow limitations, asdescribed in U.S. patent application Ser. No. 11/198,072, the contentsof which are herein incorporated by reference. Any other suitable methodof determining SDB events can be implemented by the controller 109.Alternatively, the controller 109 uses other methods of determiningbreathing patterns indicative of sleep, such as those described in U.S.Pat. No. 6,988,994.

At step 303, the controller 109 then determines sleep in a patient basedon the occurrence of SDB events or other breathing pattern indicative ofsleep. The controller 109 determines sleep based on any suitablerelationship of SDB events or the quantitative/qualitative analysis ofSDB events, or other breathing pattern indicative of sleep as describedpreviously.

For example, in one embodiment, sleep is determined by the occurrence ofa single SDB event. In other embodiments, sleep is determined based onone or more of the: number of SDB events, duration of SDB events, spreadof SDB events, types of SDB events.

In a further embodiment, at step 302, the controller 109 may also oralternatively determine sleep based on the breathing pattern of thepatient and whether the patient's measured breathing pattern is one thatis indicative of sleep. The controller compares the measured breathingpattern or breathing characteristics with stored breathing patternsindicative of sleep, such as by using methods described in U.S. Pat. No.6,988,994. If the measured breathing pattern is identical or similar,the controller determines the occurrence of sleep for a patient or in apatient. These breathing patterns indicative of sleep can be any one ofreduced tidal volume, lack of variability, reduced breath rate or achange in pulse. The controller 109 may measure the change in breathingpattern to determine sleep. In a further embodiment the controller mayalso measure particular breathing characteristics that are indicative ofsleep in a patient. The breathing characteristics have been explainedearlier.

At step 303 the controller 109 determines sleep based on the SDB events,or the breathing pattern of the patient, or the breathingcharacteristics or a combination of any two or all of these parameters.The controller 109 preferably uses a combination of all three parametersto provide better accuracy to determine sleep.

The controller 109 may determine sleep based on only SDB events, otherbreathing patterns indicative of sleep, or a combination of SDB eventsand breathing pattern changes or a combination of both. The controllercan implement any suitable algorithm that uses SDB event information orbreathing pattern information or a combination of both to determine ifsleep has occurred.

If the method determines a patient is sleeping (YES), step 303, then themethod proceeds to step 304. Otherwise, the method returns to step 301by loop 305. Loop 305 is a continuous loop and the method remains inthis loop until sleep is determined at step 303.

At step 304 the controller operates the transmitter 201 to transmit thecontrol signal to control the electronic apparatus 203 associated withthe system/PAP apparatus. The method of the present invention maycomprise a further step of receiving confirmation that the state of anappliance 203 has been switched. The controller can update itself or amemory element or a register within the controller memory that theelectronic apparatus 203 has changed state. The controller preferablyincludes registers in the controller memory. The controller uses theregisters to track the states of the various electronic apparatus 203that are being controlled. The controller may be configured to determineif the electronic apparatus is ON or OFF and store the state in theregister. The state may be a simple high low indicator, for example a 1may indicate the electronic apparatus 203 is ON and a 0 may indicate theelectronic apparatus 203 is off. The controller may be configured tostore the state and remember the previous state of the electronicapparatus 203. The controller can be configured to only change the stateof the electronic apparatus 203, by sending a control signal, if theprevious state was an ON state. The controller is preferably adapted toswitch the electronic apparatus 203 OFF when sleep is detected. The PAPapparatus 100 or control system 200 may also include further sensors todetermine the state of the electronic apparatus 203 when the PAPapparatus is started.

The PAP apparatus 100 and method defined above is advantageous becausethe PAP apparatus is adapted to automatically control electronicapparatus 203 without any input from the patient or other person. ThePAP apparatus 100 determines sleep, and automatically controlselectronic apparatus 203 when sleep is detected. In particular the PAPapparatus 100 preferably switches off electronic devices such astelevisions, radios and any other electronic apparatus. This isparticularly advantageous because the patient can sleep without beingdisturbed by the electronic apparatus being on. The invention is alsoadvantageous because the invention can save power by controlling theelectronic apparatus 203. The PAP apparatus automatically controlselectronic apparatus 203, which makes using the PAP apparatus easy forthe user since there is no user input required to control the electronicapparatus. The PAP apparatus 100 and the method is advantageous becausethe user can remain sleeping and enjoy an undisturbed sleep because thePAP apparatus automatically controls the electronic apparatuses aroundthe patient once sleep in a patient is detected.

ALTERNATIVE EMBODIMENTS

FIG. 1 shows a one embodiment of the PAP apparatus of the presentinvention. There are other alternative embodiments of the PAP apparatusthat are also possible. Some possible alternatives are described below.

In one alternative embodiment, the humidifier of the PAP apparatus isseparate to the PAP apparatus 100. The humidifier can be positionedadjacent the PAP apparatus. In this alternative embodiment the PAPapparatus only comprises a blower, a motor, flow and pressure sensors, auser interface and a controller. The humidifier can comprise a waterreservoir, a heater plate and a humidity sensor. Such a PAP system canstill be part of the present invention since the controller of the PAPapparatus can be configured to control an appliance 203 or otherelectronic device based on determining if a person is asleep from theSDB events or the patient's other breathing patterns (such as particularbreathing characteristics) indicative of sleep or a combination ofthese, determined from data measured by sensors.

In another alternative embodiment, the PAP apparatus comprises aplurality of controllers. In one form there is a second controller forcontrolling the blower and breathing circuits and the first controllercan obtain data indicative of a patient's breathing, determine sleep ina patient and control the transmitter to transmit a signal to controlelectronic apparatus. In another alternative form there can be onecontroller configured to control the electric motor and the blower.Another controller can be configured to control the heater plate. Afurther controller can be configured to control the transmitter 201 andthe power supply, with an overarching controller controlling all thesub-controllers. The controllers can also be positioned anywhere in thePAP apparatus or external to the PAP apparatus. For example thecontrollers can be stand alone components that communicate with eachother. There are a number of other possibilities and arrangements ofcontrollers that can be used in the PAP apparatus. The controller 109shown is a preferred embodiment showing a general controller thatcontrols all the functions of the PAP apparatus and is configured toimplement a preferred method as per FIG. 3. Any other arrangement ofcontrollers is also suitable for implementing the method and apparatusof the present invention and for implementing the control of electronicapparatus 203 based on SDB events or other breathing pattern indicativeof sleep.

In another alternative embodiment, the controller or controllers in thePAP apparatus are removable from the PAP apparatus. In particular, thecontroller 109 is removable from the PAP apparatus 100. The controller109 or controllers is removably attached, meaning the controller 109 orcontrollers can be removed from the PAP apparatus 100 and re-attached toPAP apparatus. This is advantageous because it allows a patient or aclinician to remove the controller to program it or troubleshoot withouthaving to transport the whole PAP apparatus 100.

In another alternative embodiment, the PAP apparatus comprises a varietyof sensors in addition to those described. Some examples are humiditysensors, mass flow sensors and sound recording sensors. The controllercan be configured to determine the occurrence of SDB events or otherbreathing pattern indicative of sleep based on input (information/data)from any of these sensors or other sensors used.

A further alternative embodiment comprises a plurality of transmittersused with the PAP apparatus and controller 109. In one form there may adedicated transmitter adapted to transmit a control signal to aparticular appliance, for example one transmitter for a television, aseparate transmitter for a radio and so on. In an alternative, thetransmitter is separate to the PAP apparatus 100 and can interface witha controller 109 (or with multiple controllers) by wired or wirelessmethods.

In a further alternative embodiment, an algorithm is be loaded on to thecontroller in a variety of ways from wired connection to wirelessmethods. In one form, the program for determining the occurrence of SDBevents or other breathing pattern indicative of sleep is programmed intothe controller at manufacture and is stored in the memory of thecontroller. In another form, a program for the method is loaded on by aportable memory device such as a USB or flash drive. In a furtheralternative form, the program for the method is loaded on to thecontroller by wireless transmission of data from a remote server or aremote location. In a further alternative form, the controller hasprograms for several methods stored on it for detecting the occurrenceof SDB events or other breathing patterns indicative of sleep. Themethod implemented by the controller depends on the type of sensors usedin the PAP apparatus and the type of sensor data. The controller usesthe appropriate program to process the sensor data in order to determinethe occurrence of SDB events or other breathing patterns indicative ofsleep.

Referring to FIG. 4, in another embodiment the electronic apparatus isan alarm device (e.g. such as an alarm clock 400 a or 400 b) and the PAPapparatus 100 is configured to operate the alarm device 400 a or 400 bto wake up a person during a sleep state that is conducive to thepatient being woken up. A patient has different sleep states. Some sleepstates result in “deep sleep” (e.g. non-REM sleep) from which it isdifficult to wake up from, and/or once woken up from will cause thepatient to be sleepy. Alternatively, some sleep states result in“shallow sleep” (e.g. REM sleep) from which it is relatively easy for apatient to wake up. In a shallow sleep state, a patient is moreconducive to being woken up. In this embodiment, the PAP apparatus 100is configured to operate the alarm device 400 a or 400 b to only wake upa patient when they are in a shallow sleep state, or as close aspossible in time to such a sleep state (either option being a sleepstate conducive to being woken).

More particularly, the PAP apparatus control system 200 comprises analarm device 400 a or is adapted to operate a separate alarm device 400a through the controller 109. The alarm device, such as an alarm clock,can be programmed in the usual way (either directly or via the PAPapparatus 100/control system 200) to sound an alarm at a desired time(e.g. 7:30 am) to wake up a patient. This is the nominal alarm time.However, the alarm device 400 a or 400 b will not automatically activatethe alarm at the desired/nominal time. To activate the alarm, the alarmdevice must receive a control signal from the PAP apparatus 100, forexample via the controller 109. To do so, the PAP apparatus controller109 monitors the time and also when the pre-programmed alarm wake uptime is. In addition, the controller 109 monitors the sleep state of thepatient using any of the methods described above. Once the time reachesthe pre-programmed desired time, the controller 109 will only send acontrol signal to the alarm device 400 a or 400 b to activate the alarmif the patient's sleep state is one conducive to waking up (e.g. ashallow sleep state). If the sleep state is not conducive to waking up,the controller 109 will not send an alarm activation control signal tothe alarm device, but rather wait until the patient has reached a sleepstate conducive to waking up and then send the control signal toactivate the alarm. So, for example, if at 7 am the patient is still indeep sleep state, the controller 109 will wait until it determines thepatient is in a shallow sleep state and then send the activation controlsignal, which may for example not be until 7.15 am.

A maximum time delay could be set (by the user or manufacturer)indicating the longest time the controller 109 should delay after thenominal alarm time before sending an alarm activation control signal.After that time, the controller 109 will send an alarm activationcontrol signal to the alarm device 400 a or 400 b irrespective of thepatient's sleep state. This avoids the possibility that the patient willsleep too long after the desired/nominal wake up time. Alternatively,the controller could have a time window either side of thedesired/nominal alarm time—e.g. 7 am+/−15 minutes, within which time thecontroller 109 can activate the alarm device 400 a or 400 b. Forexample, once 6.45 am is reached the controller 109 will send the alarmactivation control signal to the alarm device 400 a or 400 b as soon asthe patient reaches a shallow sleep state, and at latest by 7.15 am. Apatient could set the maximum delay and/or time window.

In summary, and with reference to FIG. 5, in the alarm embodiment thecontroller 109 determines if the nominal alarm time is reached, step500. It then obtains data indicative of patient breathing, step 501 anddetermines the sleep state of the patient, step 502. If the sleep stateis shallow, step 503, then the controller 109 sends a control signal tothe alarm device 400 a, or 400 b, step 504. If not, the device continuesto monitor the patient's breathing, step 501. The delay and/or timewindow could be considered also at a suitable point. It will beappreciated that this is only one embodiment and depending on timewindow tolerance and other factors, the order of determining sleep stateand whether the correct time is reached could be reversed or they couldbe determined concurrently.

1. (canceled)
 2. A breathing gases supply apparatus comprising: apositive airway pressure device, the device including: a blower, theblower comprising a fan driven by an electric motor; a pressure sensordownstream to the fan; and a flow sensor downstream or upstream to thefan, the pressure sensor and the flow sensor configured to measure apressure and flow of gases breathed by or supplied to a user; acontroller configured to receive input indicative of patient breathingfrom one or both of the pressure sensor or the flow sensor; and atransmitter remote from the positive airway pressure device, thetransmitter configured to communicate with the controller and transmit acontrol signal to an electronic apparatus that is different from thebreathing gases supply apparatus, wherein the controller is configuredto: determine a sleep state in the user based on an occurrence of abreathing pattern indicative of sleep, detected from the input receivedfrom one or both of the pressure sensor or the flow sensor, and upondetermining the sleep state, operate the transmitter to send a controlsignal to control the electronic apparatus, wherein the breathingpattern indicative of sleep is a sleep disorder breathing (SDB) event,the SDB event comprising one or more of a flow limitation, hypopnea orapnea, and wherein the controller is configured to determine the sleepstate based on any one or more of the following: a number of SDB events,a duration of SDB events, a spread of SDB events, or types of SDBevents.
 3. The breathing apparatus according to claim 2 wherein thecontrol signal is configured to change a state of the electronicapparatus.
 4. The breathing apparatus according to claim 2 wherein thecontrol signal is configured to switch on the electronic apparatus. 5.The breathing apparatus according to claim 4 wherein determining thesleep state comprises determining a shallow sleep state, wherein theelectronic apparatus is an alarm and switching on the electronicapparatus comprises operating the alarm to wake up the patient inresponse to determining the shallow sleep state.
 6. The breathing gasessupply apparatus according to claim 2 wherein the SDB event furthercomprises a rhythmic or erratic breathing pattern, or a change between arhythmic or erratic breathing pattern.
 7. The breathing gases supplyapparatus according to claim 2 wherein the breathing pattern indicativeof sleep is detected based on a measured tidal volume, a variability ofbreathing, or a breathing rate.
 8. The breathing gases supply apparatusaccording to claim 2 wherein the controller is remote from the positiveairway pressure device.
 9. The breathing gases supply apparatusaccording to claim 2 wherein the controller is further configured tocontrol the blower and a breathing circuit.
 10. The breathing gasessupply apparatus according to claim 2 wherein the electronic apparatusis one or more of: a television, a radio lights, a heater, an airconditioner, a heat pump, a media player, or an alarm clock.
 11. Thebreathing gases supply apparatus according to claim 2 further comprisingone or more of: a humidity sensor, a sound sensor, a mass flow sensor, avoltage sensor, a current sensor, a sensor or sensors to determine thestate of the electronic apparatus, an EEG sensor, a position sensor, oran accelerometer.
 12. A method of providing respiratory support using abreathing gases supply apparatus that comprises a positive airwaypressure device, the device including a blower comprising a fan drivenby an electric motor, a pressure sensor downstream to the fan, and aflow sensor downstream or upstream to the fan, the method comprising:using a controller of the breathing gases supply apparatus: receivinginput indicative of patient breathing from one or both of the pressuresensor or the flow sensor, the pressure sensor and the flow sensorconfigured to measure a pressure and flow of gases breathed by orsupplied to a user; determining a sleep state in the user based on anoccurrence of a breathing pattern indicative of sleep detected from theinput received from one or both of the pressure sensor or the flowsensor; and upon determining the sleep state, operating a transmitter incommunication with the controller to send a control signal to anelectronic apparatus to control the electronic apparatus, wherein theelectronic apparatus is different from the breathing gases supplyapparatus and the transmitter is remote from the positive airwaypressure device, wherein the breathing pattern indicative of sleep is asleep disorder breathing (SDB) event, the SDB event comprising one ormore of a flow limitation, hypopnea or apnea, and wherein the controlleris configured to determine the sleep state based on any one or more ofthe following: a number of SDB events, a duration of SDB events, aspread of SDB events, or types of SDB events.
 13. The method accordingto claim 12 wherein controlling the electronic apparatus compriseschanging a state of the electronic apparatus.
 14. The method accordingto claim 12 wherein controlling the electronic apparatus comprisesswitching on the electronic apparatus.
 15. The method according to claim14 wherein determining the sleep state comprises determining a shallowsleep state, wherein the electronic apparatus is an alarm and switchingon the electronic apparatus comprises operating the alarm to wake up thepatient in response to determining the shallow sleep state.
 16. Themethod according to claim 12 wherein the SDB event further comprises arhythmic or erratic breathing pattern, or a change between a rhythmic orerratic breathing pattern.
 17. The method according to claim 12 whereinthe breathing pattern indicative of sleep is detected based on ameasured tidal volume, a variability of breathing, or a breathing rate.18. The method according to claim 12 wherein the controller is remotefrom the positive airway pressure device.
 19. The method according toclaim 12 wherein the controller is further configured to control theblower and a breathing circuit.
 20. The method according to claim 12wherein the electronic apparatus is one or more of: a television, aradio lights, a heater, an air conditioner, a heat pump, a media player,or an alarm clock.